{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:14:10Z","timestamp":1783556050368,"version":"3.55.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic thromboembolic pulmonary hypertension (CTEPH) is rare in children, and published experience with pulmonary endarterectomy (PEA) is limited.<\/jats:p>\n                  <jats:p>We retrospectively reviewed six patients (&lt;18 years) who underwent seven PEA procedures at our center between December 2011 and September 2025. Clinical characteristics, perioperative findings, hemodynamic outcomes, and follow-up data were analyzed.<\/jats:p>\n                  <jats:p>Median age was 13 years (range, 2\u201317), and five patients were female. Five had a history of pulmonary embolism, while one presented with a hydatid cyst. Risk factors for CTEPH were hydrocephalus with ventriculoperitoneal shunt (n\u2009=\u20092), hydatid cyst disease (n\u2009=\u20091), infective endocarditis with left ventricular outflow tract obstruction (n\u2009=\u20091), and chronic kidney disease with prior COVID-19 infection (n\u2009=\u20091). Preoperative mean systolic pulmonary artery pressure (PAP) was 56\u2009\u00b1\u200923\u2009mm Hg, mean pulmonary artery pressure (mPAP) was 39\u2009\u00b1\u200915\u2009mm Hg, and mean pulmonary vascular resistance index (PVRi) was 7.51\u2009\u00b1\u20094.56 U\u00b7m2. Most patients were in World Health Organization functional class III or IV. All patients underwent PEA, with concomitant procedures required in most cases. Postoperatively, mPAP decreased to 21\u2009\u00b1\u20094\u2009mm Hg and mean PVRi to 2.36\u2009\u00b1\u20091.36 U\u00b7m2. Median intensive care unit and hospital stays were 3.5 and 9 days, respectively. There was one in-hospital mortality; all other patients recovered without major complications.<\/jats:p>\n                  <jats:p>PEA is feasible and effective in carefully selected pediatric patients, including those with complex comorbidities. Significant hemodynamic and functional improvements were achieved, supporting the role of PEA as a potentially curative therapy in this rare and challenging group.<\/jats:p>","DOI":"10.1055\/a-2875-1852","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:07:48Z","timestamp":1781737668000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Endarterectomy in Pediatric Patients: Institutional Experience"],"prefix":"10.1055","author":[{"given":"\u00c7agatay","family":"\u00c7etinkaya","sequence":"additional","affiliation":[{"name":"\u00dcsk\u00fcdar University School of Medicine, Turkey","place":["Istanbul"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nezih Onur","family":"Ermerak","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Istanbul, Turkey","place":["Istanbul"],"department":["Department of Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ela Erdem","family":"Eralp","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Turkey","place":["Istanbul"],"department":["Department of Pediatric Pulmonology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Figen","family":"Akal\u0131n","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Turkey","place":["Istanbul"],"department":["Department of Pediatric Cardiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koray","family":"Ak","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Turkey","place":["Istanbul"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eylem","family":"Tuncer","sequence":"additional","affiliation":[{"name":"The University of Health Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Turkey","place":["Istanbul"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Altug","family":"Sagir","sequence":"additional","affiliation":[{"name":"\u00dcsk\u00fcdar University School of Medicine, Turkey","place":["Istanbul"],"department":["Department of Cardiovascular Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-4552","authenticated-orcid":false,"given":"Bedrettin","family":"Y\u0131ld\u0131zeli","sequence":"additional","affiliation":[{"name":"Marmara University School of Medicine, Istanbul, Turkey","place":["Istanbul"],"department":["Department of Thoracic 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Young"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1111\/jocs.14610","article-title":"A rare childhood case of Behcet's disease and chronic thromboembolic pulmonary hypertension","volume":"35","author":"A S Wang","year":"2020","journal-title":"J Card Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3389\/fped.2020.00363","article-title":"Chronic thromboembolic pulmonary hypertension in a child with sickle cell disease","volume":"8","author":"R Spencer","year":"2020","journal-title":"Front Pediatr"},{"issue":"41","key":"ref17","doi-asserted-by":"crossref","first-page":"e12349","DOI":"10.1097\/MD.0000000000012349","article-title":"Chronic thromboembolic pulmonary hypertension as the first manifestation of nephrotic syndrome in a 12-year-old child","volume":"97","author":"F Ma","year":"2018","journal-title":"Medicine (Baltimore)"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"2045894019886249","DOI":"10.1177\/2045894019886249","article-title":"Pulmonary endarterectomy in a 12-year-old boy with multiple comorbidities","volume":"9","author":"T Verbelen","year":"2019","journal-title":"Pulm Circ"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1055\/s-0040-1710580","article-title":"Outcomes of pulmonary endarterectomy operation concomitant with cardiac procedures","volume":"69","author":"H Erdem","year":"2021","journal-title":"Thorac Cardiovasc Surg"}],"container-title":["The Thoracic and Cardiovascular 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